Puget Sound Benefits Trust



• Expand All
• Medical Forms
  • Enrollment/Beneficiary Form
  • Medical Claim Form
  • Prescription Drug Claim Form – Express Scripts
  • Short Term Disability Claim Form
  • Vision Claim Form - 2023
  • Life and AD&D Claim Form
  • Express Scripts Formulary
• Long Term Disability Forms
  • Long-Term Disability Claim Form
• Disclosures and Privacy
  • Authorization to Use or Disclose Health Information
  • Notice of Privacy Practices
  • Revocation of Authorization to Use or Disclose Health Information